Functional Outcomes of Open Reduction and Internal Fixation of T- Y Condylar Fractures of Distal Humerus by Reconstruction Plate in Lateral Column and Tension Band Wiring in Medial Column Through Extrarticular Olecranon Osteotomy

Abstract

Introduction: Distal humeral fractures in adults are complex and technically demanding injuries to manage. Operative intervention is indicated in most cases and is often complicated by difficult exposure. This study aimed to assess the functional outcome of open reduction and internal fixation of T-Y condylar fractures of the distal humerus in adults.

Methods and materials: This observational study was carried out at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka, from January 2011 to December 2012. Patients suffering from recent T-Y condylar fracture of the distal humerus were selected for the study with definite inclusion and exclusion criteria. Purposive sampling was adopted to select a total of 18 patients. Collected data were analyzed using the software SPSS (Statistical Package for Social Sciences) version 16.0 for Windows. Descriptive statistics were used to analyze the data.

Result: The study included 18 patients with a mean age of 34 years. Most injuries were due to motor vehicle accidents, with more cases on the left side. Post-surgery, 78% of patients could comb hair, 62% could feed themselves, and 89% could wear a lungi/sharee. According to the Mayo Elbow Performance Scores, 44% had excellent results, 33% good, 17% fair, and 6% poor. Overall, 78% had satisfactory outcomes at final follow-up.

Conclusion: This study concludes that the treatment of T-Y condylar fracture of the distal end of the humerus in adults with open reduction and rigid internal fixation by reconstruction plate in lateral column and tension band wiring in medial column provide adequate stability to allow for the early start of postoperative functional rehabilitation therefor better functional outcome.